Active NPI
Elise Glines
- Genetic Counselor (M.S.)
- Gulf Breeze, FL
National Provider Identifier
1356114102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Genetic Counselor (M.S.)
- License
- GC001641
- Practice address
- 321 Valencia St
Gulf Breeze, FL 32561-4031 - Phone
- (310) 913-2652
- NPI assigned
- Nov 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Genetic Counselor (M.S.) | 170300000X | GC001641 | CA | Primary |
Addresses
Primary practice location
321 Valencia St
Gulf Breeze, FL 32561-4031
Mailing address
321 Valencia Street
Gulf Breeze, FL 32561
Phone (310) 913-2652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GC001641 | CA | MD | Genetic Counselor (M.S.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1356114102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 VALENCIA STREET",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "32561",
"telephone_number": "310-913-2652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 VALENCIA ST",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325614031",
"telephone_number": "310-913-2652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLINES",
"first_name": "ELISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-02",
"last_updated": "2023-11-02",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "170300000X",
"taxonomy_group": "",
"desc": "Genetic Counselor, MS",
"state": "CA",
"license": "GC001641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.